The mean arterial pressure will be affected by factors such as drugs. If the mean arterial pressure is increased by using drugs, it is a false positive and meaningless. This corresponds to what Xie said before that drug testing should be conducted cautiously before weaning the machine.
How to do the specific operation has actually already started.
Did it?
Director Wang and others at the scene were shocked. It seemed that Xie had not mentioned any special medicine for the patient before. We have to talk about another issue. The significance of mean arterial pressure monitoring. Human perfusion is closely related to the cardiac output of the heart. Heart
The output can be measured using pio technology. If there is no pio technology, transesophageal ultrasound can be used.
Tested by echocardiography.
Xie Wanying said: "What we just measured was the heart condition under full flow support of the membrane lung, mainly measuring the left ventricular ejection fraction and the function and capacity of the right ventricle."
Since doctors are now meeting together to discuss the issue of weaning the machine, it is equivalent to saying that the values detected are very good. The next thing to do is, Xie Wanying continued to add: "Gradually reduce the patient's flow to two points
One, use transesophageal echocardiography in the middle to do the above examination. Once the left and right ventricles are found to be dilated or the blood pressure is dropped, immediately
"Restore to full flow." It turns out that this is the case. This step of weaning the machine is really done out of caution. The doctors here are swiping their pens, and no one thinks that the steps are cumbersome. Medicine is never afraid of cumbersome steps, and the more cumbersome they are.
The more you explain, the more carefully you study it.
The more we look into it, the more it appears that it is a good thing that things are under the doctor's control.
When Mr. Zhang picked up his pen notebook, he glanced at the uninvited guests at the meeting with displeased eyes.
He said that Director Xia of the National Association of U was so shameless that he came to attend meetings every day. Why, the people from the department whom he had only met once yesterday came to attend their meetings.
Can Mai Hui, a foreigner who speaks poor Chinese, really understand Teacher Xie's lecture? It turned out that someone actually brought an on-site translator to help him translate at the same time, which was amazing.
Zhang Huayao's eyebrows were almost wrinkled into two big mountains.
The shameless person must have pretended not to see his bossy expression, and craned his neck along with the other doctors present to continue listening to the lecture.
Mai Huizhen has never heard of the plan that classmate Xie mentioned. It is a plan for the future.
"When the flow rate drops to 12 to 15, and the vis index is less than 10, perform a volume load test." The vis index is the score of vasoactive drugs and inotropic drugs. It is calculated by a complicated formula and is the multiplication factor of various drugs.
Add up the doses. It can be inferred from this simple formula overview that the higher the vis index
When it is low or even equal to zero, it is best, which is equivalent to not giving the patient these drugs to support the patient's blood pressure. Under such a premise, judging the patient's heart is close to being able to truly judge the patient's own heart without assistance.
The original functional status helps doctors determine whether the patient can continue to be weaned from the machine
The volume load test is to inject albumin into the patient and finish it within a certain period of time. The purpose is to increase the blood volume to judge the response of the heart. It is to add some difficult questions to the patient to test it before weaning the patient off the machine.
Here we will use transesophageal echocardiography to check the heart function indicators mentioned before. Finally, we will use dobutamine for a few hours and then observe the heart function. If the heart parameters always maintain good stability, we can withdraw it.
